Provider Demographics
NPI:1467490094
Name:YIBAS, MARKOS
Entity Type:Individual
Prefix:DR
First Name:MARKOS
Middle Name:
Last Name:YIBAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7313 HANOVER PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3668
Mailing Address - Country:US
Mailing Address - Phone:301-220-3021
Mailing Address - Fax:
Practice Address - Street 1:7313 HANOVER PKWY STE B
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3668
Practice Address - Country:US
Practice Address - Phone:301-220-3021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054809208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics